The 2017 American Academy of Cosmetic Surgery World Congress on Liposuction meeting earlier this month in Chicago, called “The Magic of Fat,” revealed not only the latest about cosmetic procedures to remove and replace fat, but also how stem cells from fat might prove to be an evolution in cosmetic medicine.

“Fat really is magical, especially when it comes to the cosmetic patient,” says cosmetic surgeon Dr. Richard Buckley, who is a member of the American Academy of Cosmetic Surgery and the American Society of Liposuction Surgery, and who attended the international conference in Chicago. “Indeed, too much fat causes people emotional and physical distress, and sends many to practices like mine for fat reduction procedures. There is, however, so much that’s good and important about fat. For example, it’s a precious resource in our bodies. Fat is the body’s richest source of stem cells. Those stem cells have the potential to rejuvenate, repair and rebuild cells anywhere in the body, including the skin. Fat also is required for harvesting to inject into parts of the body where it might be lacking, like in an aging face.”

Procedures that address fat distribution on the face and body affect patients physically, or aesthetically, but also psychologically, according to Dr. Buckley, who is medical director at MilfordMD Cosmetic Dermatology Surgery & Laser Center, in Milford, Penn. “We’re able to transform the body by taking fat out of the body in areas where it’s unwanted and putting it in where people want or need it. For example, when we talk about fat, it has shape, structure and function. We’re able to sculpt with it to achieve so many great things. We call it ‘emotional sculpting’ because it results in so much more than a physical change.”

Because fat procedures can result in such profound change, it’s important that patients go to physicians who are trained and experienced in safely and effectively performing liposuction, body sculpting, fat reduction with minimally invasive and noninvasive devices, fat injections and more, according to Dr. Buckley. “There are so many different methods of sculpting. I think the public might think it’s all the same, but I can tell you that it’s all different. It’s different in every facility, and it’s different with every sculptor at every facility. It’s artwork. Much like you might prefer one painting or one artist over the next, the same thing is true of aesthetic procedures,” he says.

When it comes to fat removal, there are many common areas where people have fat pockets, but there also are the not-so-common troublesome areas where fat can be removed, including from the ankles and calves, as well as the pubic area. Among the more popular targets for fat removal: The jowls, which hang over the jawline and tend to make people look older. “We can take out some fat in the jowls and minimize the drooping over the jawline, which creates a shapelier jawline and helps people to look younger,” Dr. Buckley says.

Other problem areas that can be addressed with liposuction, as well as some of the newer noninvasive technologies on the market, like CoolSculpting, include the wattle, or fat deposit, on the central portion of the neck; bat wings under the arms; back fat; abdominal fat and the muffin top; excess hip and inner thigh fat; and fatty knees. The abdomen is an area in which the physician’s artistry plays a big role in patient outcomes. “We can use body sculpting to refine results and define a man’s six-pack, for example,” Dr. Buckley says.

An important area for fat reduction is the breasts, according to Dr. Buckley. “In youth, the breasts tend to be mostly glandular and firm. With time, that glandular tissue becomes more and more fatty, so, as women age, they have a higher ratio of fat to breast tissue,” Dr. Buckley says. “Women who have breasts that they feel are too big or uncomfortable might benefit from liposuction of breasts, which is nonincisional breast reduction. Interestingly, that typically results in some lifting of the breasts. We think that’s because there’s less weight pulling down on the ligaments that hold the breast tissue in place.”

The buttocks is another area, where women, especially, are bothered by having too much fat and want it reduced with liposuction, according to the cosmetic surgeon. “Liposuction of the buttocks is very popular. For optimal results, we address more than just the fat,” Dr. Buckley says. “With aging, the buttocks can become floppy, flaccid and it seems to flatten. Whereas, a youthful buttocks is more an upside-down heart shape. We can do a combination of removing fat, where it has accumulated, and putting fat back in areas that have flattened out. We sculpt curves to help differentiate, for example, the outer thigh and the buttocks. Together, these approaches address all the features that make a buttocks appear more aesthetically pleasing.”

The approach to fat transfer—taking it from one area, where it’s not wanted, and putting it into an area where it is—applies to many of the areas of the body, including the face. “That’s the beauty, or magic, of fat,” Dr. Buckley says. “We can take it from the thighs or abdomen, for example, and process it to go into the face to rebuild areas that have lost fat due to the aging process,” he says. “It’s a safe, natural and long-lasting way to rejuvenate patients and make them feel physically and emotionally better.”

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